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Hi Doctor! Lately I Ve Been Experiencing Some Left-sided Upper

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Posted on Fri, 7 Dec 2018
Question: Hi Doctor! Lately I've been experiencing some left-sided upper tooth, ear and jaw pain, and I did have a CT scan of my maxillofacial structures done, and am attaching a copy of the same. Today I just followed up with my ENT doctor, and she performed a full exam. She indicated that the mucous cyst and mucousal inflammation in the sphenoid and ethmoid sinuses on the left side could account for the left-sided pain which I am experiencing; I had actually visited my dentist two days ago and he also did a full exam and feels that my masseter and jaw muscles are extremely tight and constricted, and that could be causing the pain. My question, however, pertains to a lesion in my left nasal vestibule, which showed up on the scan and which my ENT looked at today. From what she could see, she indicated something about "inverted" and wants me to have it removed by an ENT surgeon. Apparently it is 11 by 5 mm. I have no pain in that area, no nosebleeds or congestion, etc. As a matter of fact, when I last visited the ENT three months ago, she did not even see it. Unfortunately, I cannot even get into the ENT surgeon for two and a half months. In the meantime, I saw there is something called an inverted papilloma and think that may be what she was referring to, and I saw that they can progress to squamous cell cancer and tend to reoccur even after removal. Obviously, we don't even know for sure what it is at this point, but I am super worried after googling some of these nasal cancers. Based upon my history, the CT scan report, and my lack of symptoms in my nasal area, is there any reassurance or information which you can give me? Also, my second question is this: I've had plantar warts on the soles of my feet for years now, and my podiatrist tried an autoimplantation therapy just this past January, in which she removed a tiny piece of the wart and transplanted it in the inside portion of my foot, hoping to trigger an immune response to attack the warts. Unfortunately, that doesn't appear to have succeeded, as I still have the warts. In frantically googling inverted papilloma I see that it may be caused by the HPV virus -- do you think the implantation therapy had anything to do with the lesion inside my nose? Thank you so very much!
doctor
Answered by Dr. Anders Mark Christensen (2 days later)
Brief Answer:
It seems benign

Detailed Answer:
Hi Tmmr4auiline,

The CT description of your sinuses does not suggest any malignancy. It is true that an inverted papilloma in rare cases can progress to cancer. In your case, even if it is a cancer, it appears to be localized with no signs of spread. A direct visualization by means of an endoscopy can provide a tissue sample to diagnose it definitively.
For your second question, it is extremely unlikely that the implantation therapy has caused the nasal papilloma/polyp. In fact, I find it close to impossible to think, that the wart transplantation has done anything at all, except put you through a questionable procedure.

Hope this helps, and please do not hesitate to contact me if you have further questions.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Anders Mark Christensen (13 hours later)
Hi Dr. Christensen! I cannot thank you enough for your kind and reassuring answer! You have no idea how hearing from a real physician can put these fears into a rational perspective. The combination of having health anxiety and of googling these medical conditions is certainly not a good one! What made me quite nervous is reading online about how these inverted papillomas (again, my ENT suspects it is one, but I won't know for sure until it is removed by the surgeon and sent for pathology) can be quite aggressive and reoccur even after removal. I know you certainly cannot give me any guarantees, but based upon my history and the CT scan, would you say it appears to be in the early stages and can be removed fully (the surgeon whom I will be seeing is top notch)? Thank you again for your time and kindness!
doctor
Answered by Dr. Anders Mark Christensen (11 hours later)
Brief Answer:
I am sure you will be fine

Detailed Answer:
Hi again Tmmr4aquiline,

From what I read, your prognosis is good because,
1. Even if it is an inverted papilloma, the risk of malignancy is still low.
2. Even if it is cancerous, the CT scan does not raise a suspicion of metastatic disease.

Just keep in mind that cancer is very unlikely. I am sure it will turn out to be nothing. Do not hesitate to contact me again, if need be.

Best wishes.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
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Dr. Anders Mark Christensen

General Surgeon

Practicing since :2016

Answered : 1559 Questions

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Hi Doctor! Lately I Ve Been Experiencing Some Left-sided Upper

Brief Answer: It seems benign Detailed Answer: Hi Tmmr4auiline, The CT description of your sinuses does not suggest any malignancy. It is true that an inverted papilloma in rare cases can progress to cancer. In your case, even if it is a cancer, it appears to be localized with no signs of spread. A direct visualization by means of an endoscopy can provide a tissue sample to diagnose it definitively. For your second question, it is extremely unlikely that the implantation therapy has caused the nasal papilloma/polyp. In fact, I find it close to impossible to think, that the wart transplantation has done anything at all, except put you through a questionable procedure. Hope this helps, and please do not hesitate to contact me if you have further questions.